Cardiol J
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Review
Clinical implication of gastrointestinal bleeding in degenerative aortic stenosis: an update.
Gastrointestinal (GI) bleeding due to colonic angiodysplasias can be associated with calcifying aortic stenosis (AS). GI angiodysplasias and AS are defined as chronic degenerative disorders, and the prevalence of both diseases increases with age. ⋯ Aortic valve replacement is the first line therapy for advanced stage AS-patients, but can also be an effective treatment for co-existent bleeding angiodysplasias and acquired von Willebrand disease. In this study, we tried to collect as well as systemized data about the etiopathogenesis of AS coagulation abnormalities and diagnostic, clinical and therapeutic implications of AS-patient with GI angiodysplasias.
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Review Case Reports
Lead-dependent infective endocarditis: an old problem, a new name.
This paper presents a literature review on right heart endocarditis in patients with a permanent pacemaker (PM) or implantable cardioverter-defibrillator (ICD). We postulate putting a great deal more emphasis on separation of lead-dependent infective endocarditis from other types of infective endocarditis. We stress the need for screening patients with PM/ICD and pulmonary signs using transesophageal echocardiography. Antibiotic therapy and PM/ICD removal is the treatment of choice in such patients.
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The identification of a good prognostic factor of neurological outcome after cardiac arrest is needed. S-100B protein seems to be a promising early predictor of brain damage. Yet it is necessary to reach a consensus on cut-off values, time of blood sampling and the predictive accuracy of S-100B protein. The present review summarizes the data about the clinical implications of S-100B protein after brain injury, especially in patients after cardiac arrest.
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This anesthetic drug may cause a rare condition named propofol infusion syndrome, characterized by unexplained lactic acidosis, lipemia, rhabdomyolysis, cardiovascular collapse and Brugada-like electrocardiographic pattern or Brugada electrocardiographic phenocopy changes following high-dose propofol infusion over prolonged periods of time. Several articles have contributed to our understanding of the cause of the syndrome, and the growing number of case reports has made it possible to identify several risk factors. ⋯ The favorable recovery profile associated with propofol offers advantages over traditional anesthetics in clinical situations in which rapid recovery is important. Propofol is a safe anesthetic agent, but propofol infusion syndrome is a rare lethal complication.
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Information is limited regarding the knowledge and attitudes of physicians typically involved in the referral of patients for implantable cardioverter-defibrillator (ICD) implantation. ⋯ A lack of familiarity with current clinical guidelines regarding ICD implantation exists. Primary care physicians are less aware of clinical guidelines than are cardiologists. This finding highlights the need to improve the dissemination of guidelines to primary care physicians in an effort to improve ICD utilization.